Journal article
Functional outcomes of clinically high-risk prostate cancer patients treated with robot-assisted radical prostatectomy: a multi-institutional analysis
Prostate cancer and prostatic diseases, Vol.20(4), pp.395-400
12/01/2017
DOI: 10.1038/pcan.2017.26
PMID: 28462944
Abstract
Background:
To ascertain 3-year urinary continence (UC) and sexual function (SF) recovery following robot-assisted radical prostatectomy (RARP) for clinically high-risk prostate cancer (PCa).
Methods:
Retrospective analyses of a prospectively maintained database for 769 patients with D’Amico high-risk PCa undergoing RARP at two tertiary care centers in the United States and Europe between 2001 and 2014. The association between time since RARP and recovery of UC (defined as 0 pad/one safety liner per day) and SF (defined as sexual health inventory for men (SHIM) score ⩾17) was tested in separate preoperative and post-operative Cox-proportional hazards regression models. Sensitivity analyses were conducted using continence 0 pad per day and erection sufficient for intercourse as end points for UC and SF recovery, respectively.
Results:
Mean age of the cohort was 62.3 years, and 62.1% harbored ⩾PT3a disease. Nerve sparing (unilateral or bilateral) RARP was performed in 87.7% of patients. Kaplan–Meier estimates of UC recovery at 12, 24 and 36 months after surgery was 85.2%, 89.1% and 91.2%, respectively, while 33.8, 52.3 and 69.0% of preoperatively potent men (preoperative SHIM ⩾17;
n
=548; 71.3%) recovered SF. Similar results were noted in sensitivity analyses. Patient age and year of surgery were associated with UC and SF recovery; additionally, preoperative SHIM score, degree of nerve sparing, pT3b-T4 disease and surgical margins were associated with SF recovery over the period of observation.
Conclusions:
Patients with D’Amico high-risk PCa treated with RARP may continue to recover UC and SF beyond 12 months of surgery and show promising outcomes at 3-year follow-up. Appropriate patient selection and counseling may aid in setting realistic expectations for functional recovery post RARP.
Details
- Title: Subtitle
- Functional outcomes of clinically high-risk prostate cancer patients treated with robot-assisted radical prostatectomy: a multi-institutional analysis
- Creators
- F Abdollah - Henry Ford Health SystemD Dalela - Henry Ford Health SystemA Sood - Henry Ford Health SystemJ Sammon - Henry Ford Health SystemR Cho - Henry Ford Health SystemL Nocera - Henry Ford Health SystemM Diaz - Henry Ford Health SystemW Jeong - Henry Ford Health SystemJ O Peabody - Henry Ford Health SystemN Fossati - Vita-Salute San Raffaele UniversityG Gandaglia - Vita-Salute San Raffaele UniversityA Briganti - Vita-Salute San Raffaele UniversityF Montorsi - Vita-Salute San Raffaele UniversityM Menon - Henry Ford Health System
- Resource Type
- Journal article
- Publication Details
- Prostate cancer and prostatic diseases, Vol.20(4), pp.395-400
- DOI
- 10.1038/pcan.2017.26
- PMID
- 28462944
- NLM abbreviation
- Prostate Cancer Prostatic Dis
- ISSN
- 1365-7852
- eISSN
- 1476-5608
- Publisher
- Nature Publishing Group UK
- Number of pages
- 6
- Language
- English
- Date published
- 12/01/2017
- Academic Unit
- Urology
- Record Identifier
- 9984949187402771
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